Browsing by Author "Altinbilek, Ertugrul"

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Analysis and injury paterns of walnut tree falls in central anatolia of turkey
(2014) Ersoy, Suleyman; Sonmez, Bedriye Muge; Yilmaz, Fevzi; Kavalci, Cemil; Ozturk, Derya; Altinbilek, Ertugrul; Alagoz, Fatih; Cesur, Fatma; Yildirim, Ali Erdem; Uckun, Ozhan Merzuk; Akin, Tezcan
Introduction: Falls are the second most common cause of injury-associated mortality worldwide. This study aimed to analysis the injuries caused by falls from walnut tree and assess their mortality and morbidity risk. Methods: This is a retrospective hospital-based study of patients presenting to emergency department (ED) of Ahi Evran Univercity between September and October 2012. For each casualty, we computed the ISS (defined as the sum of the squares of the highest Abbreviated Injury Scale (AIS) score in each of the three most severely injured body regions). Severe injury was defined as ISS >= 16. The duration of hospital stay and final outcome were recorded. Statistical comparisons were carried out with Chi-Square test for categorical data and non-parametric spearman correlation tests were used to test the association between variables. A p value less than 0.05 was considered to be statistically significant. Results: Fifty-four patients admitted to our emergency department with fall from walnut tree. Fifty (92.6%) patients were male. The mean age was 48 +/- 14 years. Spinal region (44.4%) and particularly lumbar area (25.9%) sustained the most of the injuries among all body parts. Wedge compression fractures ranked first among all spinal injuries. Extremities injuries were the second most common injury. None of the patients died. Morbidity rate was 9.25%. Conclussion: Falls from walnut trees are a significant health problem. Preventive measures including education of farmers and agricultural workers and using mechanized methods for harvesting walnut will lead to a dramatic decrease in mortality and morbidity caused by falls from walnut trees.
Bedside Heart Type Fatty Acid Binding Protein (H-FABP): Is an Early Predictive Marker of Cardiac Syncope
(2015) Sonmez, Bedriye Muge; Ozturk, Derya; Yilmaz, Fevzi; Altinbilek, Ertugrul; Kavalci, Cemil; Durdu, Tamer; Hakbilir, Oktay; Turhan, Turan; Ongar, Murat; 0000-0003-2529-2946; 26564283; AGG-1308-2022
Objective: To determine the value of bedside heart-type fatty acid binding protein in diagnosis of cardiac syncope in patients presenting with syncope or presyncope. Methods: The prospective study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, between September 1, 2010, and January 1, 2011, and comprised patients aged over 18 years who presented with syncope or presyncope. Patients presenting to emergency department within 4 hours of syncope or presyncope underwent a bedside heart-type fatty acid binding protein test measurement. SPSS 16 was used for statistical analysis, Results: Of the 100 patients evaluated, 22(22%) were diagnosed with cardiac syncope. Of them, 13(59.1%) patients had a positive and 9(40.9%) had a negative heart-type fatty acid binding protein result. Consequently, the test result was 12.64 times more positive in patients with cardiac syncope compared to those without. Conclusions: Bedside heart-type fatty acid binding protein, particularly at early phase of myocardial injury, reduces diagnostic and therapeutic uncertainity of cardiac origin in syncope patients.
Canadian C-Spine Criteria and Nexus in The Spinal Trauma: Comparison at A Tertiary Referral Hospital in Turkey
(2017) Caltili, Cilem; Ozturk, Derya; Altinbilek, Ertugrul; Yapar, Nikola; Serin, Mehmet; Gunduz, Harika; Kayipmaz, Afsin Emre; Kavalci, Cemil; https://orcid.org/0000-0003-2529-2946; AAC-2597-2020; AGG-1308-2022
Objective: Spinal trauma and the ensuing neurological problems transform a person's social life and result in significant economic and non-economic burden. We compared the diagnostic performances of the National Emergency X-Radiography Utilization Study (NEXUS) Low-Risk Criteria (NLC) with the Canadian C-Spine Rule (CCSR) criteria in identifying lesions. Methods: This retrospective study was conducted on 724 patients after obtaining approval from the ethical board of the hospital. The demographic characteristics of the patients (age, gender), their medical histories, season, trauma occurrence mechanism, hospital arrival time following the development of spinal trauma, their Glasgow Coma Score at the time of admission, their complaints at the time of admission (such as pain, paresthesia, and loss of muscle strength), their spinal trauma lesion levels, and compatibility of the applied viewing methods with the NEXUS and CCSR criteria were collected from the patients' files. Results: A total of 2,442 cases were diagnosed with spinal trauma. For patients with a spinal fracture, the sensitivity and specificity of CCSR were 99.7% and 17.9%, respectively, while the sensitivity and specificity of NEXUS were 97.6% and 27.2%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) of CCSR were, respectively, 16.3% and 99.7%, while the PPV and NPV of NEXUS were 17.7% and 98.6%, respectively. Conclusions: This study showed that the CCSR criteria are more sensitive than the Nexus criteria.
A Comparison of Human Prothrombin Complex and Fresh Frozen Plasma for Reversal of Warfarin Anticoagulant Effect in The Emergency Department
(2016) Altinbilek, Ertugrul; Ozturk, Derya; Ikizceli, Ibrahim; Kavalci, Cemil; https://orcid.org/0000-0003-2529-2946; AGG-1308-2022
Introduction: Warfarin, the most commonly used oral anticoagulant worldwide. Bleeding represents the most significant complication of warfarin therapy. The aim of the present study was to compare the efficacies of Human Prothrombin Complex (PCC) and Fresh Frozen Plasma (FFP) for reversal of warfarin-induced anticoagulant effect in the emergency department. Materials and methods: This observational, retrospective study was retrospectively conducted at Sisli Hamidiye Etfal Training and Research Hospital. The study included 32 patients aged over 18 years who presented to the emergency department with warfarin-induced INR elevation and major bleeding. The patients were divided into PCC (Group 1) and FFP (Group 2) groups. The two groups were compared with each other with respect to age, gender distribution, duration of emergency department stay, warfarin dosing schedule (mg/day), bleeding site, amount of PCC (number*10 ml/IU) or FFP (number*200 ml) used for treatment, pre-treatment INR, aPTT levels, and INR, PT, and aPTT levels 15 minutes after FFP and 240 minutes after PCC administration. Results: The two groups were not significantly different with respect to age and gender distribution (p > 0.05). PCC group had an average duration of emergency department stay of 4.8 hours whereas FFP group had an average duration of emergency department stay of 12.25 hours (p<0.05). The number and cost of PCC was significantly greater than FFP (p<0.05). However, the volume of drug was significantly lower in the PCC group (p<0.05) Conclusion: PCC has a limited role in clinical practice due to its cost and limited availability. However, with the possible exceptions of blood transmissible diseases, volume loading, and loss of time, administration of a combination of FFP and vitamin K is not a medically inappropriate practice.
Comparison of the Canadian CT head rule and the new orleans criteria in patients with minor head injury
(2014) Kavalci, Cemil; Aksel, Gokhan; Salt, Omer; Yilmaz, M. Serkan; Demir, Ali; Kavalci, Gulsum; Ozel, Betul Akbuga; Altinbilek, Ertugrul; Durdu, Tamer; Yel, Cihat; Durukan, Polat; Isik, Bahattin
Aim: The aim of the study was to compare the New Orleans Criteria and the New Orleans Criteria according to their diagnostic performance in patients with mild head injury. Methods: The study was designed and conducted prospectively after obtaining ethics committee approval. Data was collected prospectively for patients presenting to the ED with Minor Head Injury. After clinical assessment, a standard CT scan of the head was performed in patients having at least one of the risk factors stated in one of the two clinical decision rules. Patients with positive traumatic head injury according to BT results defined as Group 1 and those who had no intracranial injury defined as Group 2. Statistical analysis was performed with SPSS 11.00 for Windows. ROC analyze was performed to determine the effectiveness of detecting intracranial injury with both decision rules. p < 0.05 was considered statistically significant. Results: 175 patients enrolled the study. Male to female ratio was 1.5. The mean age of the patients was 45 +/- 21,3 in group 1 and 49 +/- 20,6 in group 2. The most common mechanism of trauma was falling. The sensitivity and specificity of CCHR were respectively 76.4% and 41.7%, whereas sensitivity and specificity of NOC were 88.2% and 6.9%. Conclusion: The CCHR has higher specificity, PPV and NPV for important clinical outcomes than does the NOC.
Effects of Drug Use on the Development of Diabetic Ketoacidosis
(2015) Koyuncu, Murat; Ozturk, Derya; Altinbilek, Ertugrul; Yapar, Nikola; Karakisa, Halit; Kavalci, Cemil; Ikizceli, Ibrahim; 0000-0002-9825-4716; 0000-0003-2529-2946; 0000-0003-4201-8850; 0000-0001-7446-1641; D-1981-2019; AGG-1308-2022; AAB-1368-2019
Introduction: Diabetic Ketoacidosis (DKA) is a condition in which the body must use adipose and protein deposits as intracellular energy sources due to a lack of insulin. In the current study, we aimed to investigate the effects of drug use on the development of DKA and on clinical parameters in patients who presented to the Emergency Department (ED) with the diagnosis of DKA. Materials and methods: This study was retrospectively conducted in Sisli Etfal Training and Research Hospital between October 1, 2011 and March 31, 2013. The following parameters were recorder for each patient: age, gender, complaints, history of drug use, cause of DKA, pH, HCO3 levels, time spent in the ED, treatment outcomes and hospitalization durations. Results: The mean age of the patients was 42.61 +/- 8.6 years, and 58% (n=43) of them were female. 20.3% (n=15) of the patients were drug free. 63.5% (n=47) of the patients were followed up with in the ward, 12 (16.5%) were followed up with in the ED and 20% (n=15) were followed up with in the intensive care unit (ICU). The mean duration of stay in the ED was 15 hours, and the mean hospitalization time was 10 days. The mortality rate was 2.7%(n=2). When the effects of the drug use on DKA were examined, there were no statistically significant differences between the patients in terms of acidosis condition, mortality, clinic of hospitalization and durations of follow-up and treatment (p>0.05). The most important factor causing ketoacidosis was the presence of infection (40.5%, n=30), while the most common symptom was nausea/vomiting (51.4%, n=38). Conclusion: We observed that in patients with DKA, drug use does not affect mortality and morbidity.
Hemophagocytic Syndrome: A Case Report
(2016) Ozturk, Derya; Altinbilek, Ertugrul; Caltili, Cilem; Kavalci, Cemil; 0000-0003-4201-8850; 0000-0003-2529-2946; 0000-0001-8910-7004; AAB-1368-2019; AGG-1308-2022; AAK-9102-2021
Hemophagocytic syndrome, a serious clinical condition accompanying systemic inflammatory disorders, is characterized by massive hypercytokinemia as a result of excessive activation and proliferation of T-lymphocytes and macrophages. This article aims to remind clinicians of the hemophagocytic syndrome in the differential diagnosis of patients with fever, pancytopenia, and hepatosplenomegaly. This condition can be highly fatal despite the administration of appropriate therapy. Early diagnosis of hemophagocytic syndrome is of utmost importance, as a delay in diagnosis significantly worsens the prognosis, and treatment should be tailored to the underlying pathology.
Neutrophil/lymphocyte ratio and Red blood cell distribution width are independent risk factors for 30-day mortality in Gastrointestinal system bleeding patients
(2019) Altinbilek, Ertugrul; Ozturk, Derya; Kavalci, Cemil
Background. In this study, we aimed to examine demographic and endoscopic features of patients with GI bleeding to determine the factors affecting 30-day mortality. Method. Patient's demographic features, laboratory outcomes, comorbidities, drug use, endoscopy outcomes, Glasgow-Blatchford scores, and mortality status were examined. The factors affecting 30-day mortality were investigated. Results. The mean age of the patients was 58.2 +/- 17.4 years, and 72.1% were male patients. 30-day mortality rate was found to be 14.4%. The mean age of patients who died was high (p<0.05). The incidence of mortality was high in the presence of comorbidity, malignancy, and cirrhosis (p<0.05). Systolic blood pressure was low in the patients who died (p<0.05). No significant correlation was found between mortality and gender, symptoms, predisposing factors, lesion type and Forrest score, diastolic blood pressure and heart rate (p>0.05). Urea, neutrophils, red blood cell distribution width / platelet ratio, neutrophil / lymphocyte ratio and RDW levels were high, and hemoglobin level was significantly low in patients with a mortal progression (p<0.05). No significant correlation was found between mortality, and platelet and lymphocyte levels (p>0.05). Glasgow-Blatchford score was significantly higher in patients who died (p<0.05). Conclusion. Many factors affect 30-day mortality in GI bleeding. It should be remembered that follow-up of patients with an advanced age who have comorbidity and impaired hemodynamics should be kept for long, and that these patients are at a high risk for mortality. According to our results, NLR and RDW are independent factors that determine the 30-day mortality in upper GI bleeding.
Successful application of acute cardiopulmonary resuscitation
(2015) Ozturk, Derya; Altinbilek, Ertugrul; Koyuncu, Murat; Sonmez, Bedriye Muge; Caltili, Cilem; Ikizceli, Ibrahim; Kavalci, Ibrahim; Kavalci, Cemil; Kavalci, Gulsum
Objective: To compare the quality and correct the deficiencies of cardiopulmonary resuscitation (CPR) procedures performed in patients who developed cardiopulmonary arrest before or after Emergency Department admission. Methods: This study was conducted on patients who were applied CPR at Sisli Etfal Training and Research and Research Hospital, Emergency Department between 01 January 2012 and 31 December 2012. Chi-square and Mann-Whitney U test were used to compare the patients' data. The study data were analyzed in SPSS 18.0 software package. A P value less than 0.05 was considered statistically significant. Results: A total of 155 patients who were applied CPR were included in the analysis. Among the study patients, seventy eight (50.3%) were brought to Emergency Department after developing cardiopulmonary arrest while 77 (49.7%) developed cardiopulmonary arrest at Emergency Department. The mean age of the study population was (66 +/- 16) years and 64% of the patients were male. The initial rhythms of the CPR-applied patients were different (P < 0.05). There were no significant differences between the groups with respect to the treatment protocols or CPR responses (P > 0.05). The CPR response time was longer in ED (P < 0.05). The survival rate was lower in the trauma patients who developed cardiopulmonary arrest at ED (P < 0.05). Conclusions: The scientific data obtained in this study suggest that an early response and therapy improves outcomes in CPR procedure.